Rearfoot / Ankle · Trauma · Infection & Wound · Advanced
Highway Collision
Podiatric surgery residency interview case. Work through it the way you would at an interview: take the history, ask for the exam and imaging, then commit to a diagnosis and plan.
Chief complaint
"I hurt my leg in a car accident."
42-year-old male seen in the podiatry clinic after a motor vehicle accident.
History of present illness
Driver in a motor vehicle collision. Immediate pain and deformity of the right distal leg and ankle; unable to bear weight. Seen in the ED, placed in a splint and referred to clinic.
- Restrained driver, airbag deployed; no LOC; cleared of other injuries in the ED
- Pain 8/10 in the distal leg and ankle; no numbness or tingling
- Skin was intact in the ED; increasing swelling since
- Tetanus up to date; last meal this morning
Questions a strong candidate asks at this step
- Mechanism, speed, restraint, other injuries (ATLS — is the trauma work-up complete?)
- Time since injury; ability to bear weight
- Pain, numbness, tingling — 6 Ps; compartment symptoms (pain out of proportion, pain with passive stretch)
- Open wounds; what treatment was given in the ED
- NPO status, tetanus status
Present the rest of the case
Past history, exam, imaging, assessment, plan and discussion questions, with model answers, are in the interactive trainer. The diagnosis is kept there on purpose so you can practice committing to one.